? Wally - 10/23 AMPS=137,+3=418,+7=454,PMPS=532,+2=476,+3=341,+6=112,+9=100

Can anyone take a look at Wally's spreadsheet and give me your thoughts on what might be going on? He's been having great AMPS numbers and then spikes all day. If I can do it, I'll try and take a few post PM tests today and see what he's doing during the night.

I changed the battery in the AlphTrak2 meter tonight and the insulin pen is pretty new and looks fine. And I opened a new vial of strips and recalibrated the meter after the PM +2 reading.
He's acting normally and eating well so I'm wondering if going back up to 1.75 is causing these 'bounces' if they are bounces???

https://docs.google.com/spreadsheet...xsVTVKP1CIT7LvAbhgEDzCATs/edit#gid=1182885903

 

I’m not advanced enough to say what going on, I’m sorry. I want to say they do look like bounces but as I posted to the FB group I’m wondering if the PetSure strips might be an issue? I saw you said you used them ‘mostly’. I only ask because the reads with the set I bought were wonky and I ended up not using them!
I also see you are using TR, but you are holding the doses for a bit longer. Is there a reason? I have only had one diabetic cat, and we just reached remission using TR back in September. I switched him a lot faster and I think that kicked his pancreas into gear. I cannot recall the nadirs for holding, so you may very well have a good reason. I switched to TR because I was tired of holding doses for 7 days with Max so high. Holding at number under 100 were a lot easier. Max doesn’t have any other health issues that would have prevented remission, so I’m not sure if Wally has any other issues that could make him stay on the higher side? I will tag a few people who helped me quite a bit with Max. I hope someone has an answer for you!
I do remember that if the PMPS was lower than nadir (so no clear nadir) with TR, it was indicative of a bounce. Max had a few of those, but they seemed to clear faster and the higher numbers were much lower than his usual bounce.
@carfurby @tiffmaxee @Chris & China (GA)

 

I think you've nailed it. He's dropping at night (when many cats do) and bouncing during the day. TR requires two tests per cycle, those before bed tests are key to keeping him safe and letting you know what he's doing overnight. You've skipped testing the last night.

I also agree with Rebecca on the dose. We hold doses with TR for 6-10 cycles if nadirs are under 200. Tonight is cycle 10.

 

I've been using the PetSure strips for a long time and have had very good luck with them. When I first started using them I did side-by-side comparisons with the AlphaTrak2 strips and the results were very close so I don't think it's the strips. Re: holding the dose. I've been hesitant to up it because he's hypo'd before at the higher dose and then he'll give me a good nadir so I think I should hold the current dosing for a bit longer.

 

A cat's insulin needs change over time. Anything over two weeks can be considered ancient history. Glucose toxicity can set in if you hold a dose too long.

 

Glad to know the strips worked for you! I’m a little jealous, lol!
It was just something I wasn’t sure about as I’m not that fluent in feline diabetes. And yes, I remember the worry over increasing doses as well. Max always seemed to drop at night more so than day time, but I just decided that’s what I was going to do and pretty much every 3 days he was increased. Once he hit 2U, he dropped quickly back down. The first few times I’d feed the MC food quite a bit and then his BGLs would rise too high. I was lucky in that he only once apparently had a true hypo event (way back at the start of treatment before I found FDMB). After that the rest were just ‘low numbers’ events. It could be that I tested so much I would catch a drop and start treating conservatively, rather than catching a really low low and then have to treat quickly. He could be as low as 46 and be just fine (no symptoms of a hypo). I learned some cats can be fine at low numbers while it affects others quite easily. Part of the ECID (every cat is different) motto. It took me a few low drops to learn that all Max needed was a few teaspoons of Fancy Feast gravy lovers and a few Temptations cat treats to keep him from dropping too low. It was enough to raise BGLs a little (and stop them from dropping more), but that combo didn’t cause his levels to spike way up. That way by nadir he’d start to come up on his own and I wasn’t looking at high reads later. It totally helped in his run for remission because I was able to keep him in the greens consistently. It was a learning curve for sure, but it was totally worth it. I am also a stay at home mom (with kids learning online) & caregiver to my elderly dad, so I could afford to get only a few hours sleep at night. It’s good to see Wally hit the blues at night, now it’s time to train that liver to stop freaking out and get the pancreas back in charge.